徐景藩基于脾阴理论治疗消化系统疾病思想撷菁

XU Jingfan's Experience in Treating Digestive Diseases based on Spleen-yin Theory

总结徐景藩教授运用脾阴理论治疗消化系统疾病的经验。认为脾为阴土,其性濡静,脾阴脾气,互为因果。临证以脾阴理论为指导,治疗消化系统疾病时谨守病机,病证结合,以“甘”字立法,体用结合。提出治疗溃疡性结肠炎宜甘淡甘平,常用慎柔养真汤;治疗慢性萎缩性胃炎宜甘淡凉润,甘以入脾,淡以利阴,药如扁豆、山药、莲子、石斛、白芍之属,凉润养胃体而滋胃用,药如麦冬、知母、沙参、芦根、竹茹之属,或用参苓白术散;治疗功能性便秘宜甘凉滋润,常用药如火麻仁、桃仁、郁李仁、杏仁、当归、白芍之属;治疗肝硬化腹水宜甘寒淡渗,常用一贯煎、参麦地黄汤等。同时强调注意阴无骤补,不可急功。

This paper summarized XU Jingfan's experience in treating digestive diseases based on spleen-yin theory.It is believed that the spleen is yin earth,whose nature is moist and calm,and the spleen yin and spleen qi are mutual cause and effect.In treatment of digestive diseases,XU Jingfan took the spleen-yin theory as the guide,adhered to the pathogenesis,combined disease and syndrome,used the “sweet” method,and integrated the form and function.It is proposed that ulcerative colitis should be treated with sweet-bland and sweet-neutral medicinals,and Shenrou Yangzhen Decoction (慎柔养真汤) is usually used.For the treatment of chronic atrophic gastritis,it is suggested to use sweet-bland and cool-moistening medicinals,as the sweet intends to enter the spleen,and the bland moistens yin,such as Biandou(Semen Lablab Album),Shanyao(Rhizoma Dioscoreae),Lianzi(Semen Nelumbinis),Shihu(Caulis Dendrobii) and Baishao(Radix Paeoniae Alba);to cool and moisten the form and enrich the function of the stomach,medicinals such as Maidong(Radix Ophiopogonis),Zhimu(Rhizoma Anemarrhenae),Shashen(Radix Adenophorae seu Glehniae) and Lugen(Rhizoma Phragmitis),Zhuru(Caulis Bambusae in Taenia),as well as Shenling Baizhu Powder (参苓白术散) can be used.For functional constipation,it is advised to use sweet,cool and moistening medicinals,usually with Huomaren(Fructus Cannabis),Taoren(Semen Persicae),Yuliren(Semen Pruni),Xingren(Semen Armeniacae Amarum),Danggui(Radix Angelicae Sinensis) and Baishao(Radix Paeoniae Alba).In the treat-ment of liver cirrhosis ascites,sweet-cold and bland-percolating medicinals should be taken,and usually Yi Guan Decoction (一贯煎) and Shenmai Dihuang Decoction (参麦地黄汤) are used.At the same time,it is suggested not to supplement in a sudden,and not to be rushed to success.